In most facilities, we will have monoplace chambers which are single chamber vessels (one patient per chamber) pressurized to a specific depth with 100% oxygen delivery. In a few facilities, we will have multiplace chambers which allow for more than one individual in a much larger chamber vessel. In multiplace chambers, each patient will receive 100% oxygen delivered through a hood, but the entire chamber will be pressurized with air. Please see photos below (we will insert a stock photo of a multiplace versus a monoplace chamber).
Debridements involve our wound care specialists using advanced tools to debride (clean) debris and dead tissue off a chronic wound for the wound to heal. The process is generally performed once a week to allow for a clean wound bed to facilitate wound healing.
Cellular or tissue-based products
Our wound care providers will employ the use of advanced tissue (cellular or acellular) placement to accelerate chronic, non-healing wounds. All products are FDA approved and are generally considered after a wound has been present for at least 4 weeks in duration. Placement is done once a week until wound closure and does not require surgery.
Negative pressure wound therapy
Advanced dressings used at our facilities will include negative pressure wound therapy, which employs negative pressure (or vacuum) device connected to a wound dressing (specialty foam) that assists with wound debris removal, drainage control, and tissue growth stimulation. Placement of devices can be used, for example, in deep surgical wounds and allow for a faster time to heal. Such devices are placed at minimum once a week and will require dressing changes up to three times a week.
Total contact casting
Considered by Medicare to be the “gold standard” in healing plantar foot ulcers, total contact casting is utilized in our facilities to offload chronic wounds found on the bottom of the foot. Such a therapy allows for patients to continue ambulating with a “permanent insert” to prevent repetitive pressure injury while the patient is attempting to heal. Placement of a total contact cast is applied and then re-applied once a week. Initial placement is generally twice the first week to ensure that patients do not have complications.
For patients with ulcers related to chronic lower extremity swelling (whether due to venous insufficiency or lymphedema), multi-layer compression wraps are placed by our experienced wound care staff to address edema. Edema management is extremely important in healing ulcers related to lower extremity swelling and the team will also consider appropriate additional vascular consultation and ordering of compression pumps or lymphedema therapy to address all aspects of the disease state. Compression wraps are generally done twice a week initially followed by once a week for maintenance after each wound care visit until healing.
Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is a medical treatment approved by the FDA for clinical use in certain indications for chronic, non-healing wounds and some non-wound indications to facilitate patient healing. Therapy is considered adjuvant in most all cases and not a “cure” for an illness. For hypoxic wounds that require the formation of new blood vessels to heal, such as in diabetic foot ulcers, hyperbaric oxygen therapy may be assistive to prevent downstream complications (i.e., amputation). Hyperbaric oxygen therapy may also assist in enhancing effects of antibiotics on bone infection in cases of chronic osteomyelitis and / or acute osteomyelitis in relation to diabetic foot ulcers. Other common indications requiring HBOT include compromised flaps or grafts, acute peripheral arterial emboli, soft tissue delayed radiation tissue injury, osteoradionecrosis of the jaw, irradiation cystitis, necrotizing fasciitis, carbon monoxide poisoning, arterial gas embolism or decompression sickness (in relation to scuba diving complications). Hyperbaric oxygen therapy treatments are generally 90 minutes daily, five days a week, and up to 30 – 40 treatments depending on the treatment indication. Our provider team will do a comprehensive assessment of your potential need for such therapy at the initial consultation.